Gomes Kirla Wagner Poti, Luz Ana Joicy Pinheiro, Felipe Marcos Rainier de Brito, Beltrão Lara Amorim, Sampaio André Xenofonte Cartaxo, Rodrigues Carlos Ewerton Maia
a Department of Rheumatology , Hospital Geral de Fortaleza , Ceará , Brazil.
b Post-Graduate Program in Medical Sciences , University of Fortaleza (UNIFOR) , Ceará , Brazil.
Mod Rheumatol. 2018 Mar;28(2):258-263. doi: 10.1080/14397595.2017.1316813. Epub 2017 May 9.
To determine the prevalence of metabolic syndrome (MetS) in patients with rheumatoid arthritis (RA) and controls from Northeastern Brazil and to verify its association with specific RA parameters and cardiovascular risk factors.
The prevalence of MetS was assessed cross-sectionally in 338 RA patients from a single center and 84 age and gender-matched controls from the local community. MetS was defined according to NCEP/ATPIII guidelines. Disease activity was assessed with CDAI, SDAI and DAS28 scores. Independent risk factors for MetS in RA patients were identified by multivariate logistic regression.
The prevalence of MetS was higher in RA patients than in controls (51.3% vs. 21.8%; p < .001). RA patients had a higher frequency of hypertension and type-2 diabetes mellitus, greater waist circumference (WC), higher blood glucose levels and lower HDL levels. DAS28, CDAI and SDAI scores were higher and high disease activity was more frequent in MetS patients. The multivariate logistic regression identified BMI (OR = 1.12, 95% CI = 1.05-1.20; p < .001) and disease activity (OR = 1.23, 95% CI = 1.04-1.47; p = .016) as independent risk factors for MetS in patients with RA.
RA in patients from Northeastern Brazil was found to be associated with increased WC, high prevalence of MetS (one of the highest in the world) and disease activity. Patients with MetS displayed a higher frequency of cardiovascular risk factors, indicating the need for better control of disease activity and modifiable risk factors for cardiovascular disease (CVD).
确定巴西东北部类风湿关节炎（RA）患者和对照组中代谢综合征（MetS）的患病率，并验证其与特定RA参数和心血管危险因素的关联。
对来自单一中心的338例RA患者和当地社区84例年龄及性别匹配的对照组进行横断面评估，以确定MetS的患病率。根据NCEP/ATPIII指南定义MetS。采用CDAI、SDAI和DAS28评分评估疾病活动度。通过多因素逻辑回归确定RA患者中MetS的独立危险因素。
RA患者中MetS的患病率高于对照组（51.3%对21.8%；p < 0.001）。RA患者高血压和2型糖尿病的发生率更高，腰围（WC）更大，血糖水平更高，高密度脂蛋白（HDL）水平更低。MetS患者的DAS28、CDAI和SDAI评分更高，疾病活动度高的情况更常见。多因素逻辑回归确定体重指数（BMI）（比值比[OR]=1.12，95%置信区间[CI]=1.05 - 1.20；p < 0.001）和疾病活动度（OR = 1.23，95% CI = 1.04 - 1.47；p = 0.016）是RA患者中MetS的独立危险因素。
发现巴西东北部患者的RA与腰围增加、MetS高患病率（世界上最高之一）和疾病活动度相关。MetS患者心血管危险因素的发生率更高，这表明需要更好地控制疾病活动度和心血管疾病（CVD）的可改变危险因素。
